胃腔定植菌在昏迷病人肺部感染发病中的影响研究  

The impact of gastric colonization on the pathogenesis of pneumonia in comatose patients

作　　者：杨秀洁[1] 简燕[1] 卜会驹[1] 林小茂[1] 秦志梅[1] 

机构地区：[1]中山大学附属东华医院ICU,广东523110

出　　处：《临床肺科杂志》2009年第5期585-586,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨在昏迷的病人中实行胃腔定植菌监测对防治肺部感染的临床意义。方法观察重症监护室(ICU)中发生肺部感染(44例)和没有发生肺部感染(23例)的昏迷病人抑酸药应用情况及胃液PH值,胃液及呼吸道分泌物培养结果。结果发生肺部感染的昏迷病人抑酸药应用时间明显较长(4.3±1.7天vs2.9±1.2天,P<0.05),胃液PH值(3.9±1.6vs1.7±0.7,P<0.05)和胃液培养阳性结果(31%vs13%)明显增高,胃液培养和肺部病原体菌种的一致性和构成比类似。结论胃液PH值和胃腔定植菌监测对于防治昏迷病人的肺部感染有重要的临床意义。Objective To research the clinical significance of gastric colonization monitoring on prevention and curing of pneumonia in comatose patients. Methods Prospective study was conduted and observation was made on comatose patients with pneumonia （44 examples） and comatose patients with no pneumonia （23 examples） in the intense care unit （ICU）. The measures included usage of antiacid medicine, PH index of gastric juice, cultivation of gastric juice and tracheal secretion. Results Comatose patients with pneumonia , in comparison with those no pneumonia, had longer time of usage of anti-acid medicine （4. 3 ± 1.7 days vs 2. 9 ± 1.2 days,P 〈0. 05）, higher PH index of gastric juice （3.9 ± 1.6 vs 1.7 ± 0. 7, P 〈 0. 05 ） and higher masccline result rate of gastric juice cultivation （31% vs 13 % ）. Pathogeny of gastric juice was similar to that of lower respiratory secretion. Conclusion PH index of gastric juice and gastric colonization monitoring has important clinical significance on prevention and curing of pneumonia in comatose patients.

关 键 词：胃腔定植菌 昏迷 肺部感染 

分 类 号：R563.1[医药卫生—呼吸系统]